What is Cushing syndrome?

Cushing syndrome is a condition caused by having too much of a hormone called cortisol in the body. Cortisol helps your body function normally, but when there’s too much of it, it can cause a range of symptoms and health problems like high blood pressure, weight gain, muscle weakness, and thin skin.

Cortisol is made by the adrenal glands, which sit on top of each kidney. Normally, the adrenal glands produce cortisol after receiving signals from the pituitary gland, a small organ located near the brain.

What causes Cushing syndrome?

Cushing syndrome can develop for several reasons:

• Taking steroid medications: Steroids, which act like cortisol, are used to treat conditions like asthma or arthritis. Taking high doses for a long time can cause Cushing syndrome.

• Abnormal growths in the pituitary gland or other parts of the body: These can send signals to the adrenal glands to produce too much cortisol.

• Adrenal gland problems: Sometimes, the adrenal glands themselves produce too much cortisol.

What are the symptoms of Cushing syndrome?

Symptoms of Cushing syndrome can vary, but they often include:

• Weight gain, especially in the face, neck, back, or belly

• Thin skin that bruises easily or develops wide stretch marks

• Irregular or missed periods (in women)

• Increased facial hair (in women)

• Oily skin or acne

• Muscle weakness, especially in the upper arms or legs

• Fragile bones that break easily

• High blood sugar levels (diabetes)

• High blood pressure or heart problems

• Mood changes, such as depression, anxiety, or irritability

• Trouble with memory, attention, or learning

• Increased risk of infections

• Blood clots in the legs

Without treatment, these symptoms can worsen and become life-threatening.

How is Cushing syndrome diagnosed?

To diagnose Cushing syndrome, your doctor will discuss your symptoms, perform a physical exam, and order lab tests to measure your cortisol levels in blood, urine, or saliva. If cortisol levels are high, more tests, such as blood work or imaging (CT or MRI scans), may be needed to determine the cause.

How is Cushing syndrome treated?

Treatment depends on the cause of the condition:

• Steroid use: If your symptoms are due to taking steroid medications, your doctor will work with you to slowly reduce the dose.

• Surgery: Surgery may be needed to remove abnormal growths in the pituitary gland or other areas or to remove one or both adrenal glands.

• Radiation therapy: Radiation may be used to target abnormal cells.

• Medications: Medicines can help lower cortisol production by the adrenal glands.